Interim arrangements frequently asked questions

Interim arrangements as a result of the delay of the National Cervical Screening Program from 1 May to 1 December 2017

Page last updated: 21 June 2017

It is important to continue to encourage women aged between 18-69, who have ever been sexually active, to have a Pap test when they are due. Eighty per cent of cervical cancers occur in women who have never screened or do not screen regularly, so it is important to encourage all eligible women to keep up to date with their screening.

Regular screening remains the best way to prevent cervical cancer, and women should not delay screening in anticipation of the new Cervical Screening Test.

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The National Cancer Screening Register will now commence on 1 December 2017 for the National Cervical Screening Program. The implementation of the renewed National Cervical Screening Program is contingent upon a high quality nationally consistent register to support the new Cervical Screening Test. Until the National Cancer Screening Register is in place, the well-established state and territory cervical screening registers will continue to support the program.

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No. The decision to introduce the new Cervical Screening Test occurred following an independent and comprehensive review of the cervical screening evidence by the Medical Services Advisory Committee (MSAC). The MSAC Outcomes Report outlines the evidence which supports the recommendation to replace the two yearly Pap test with the five yearly primary human papillomavirus (HPV) test. The delay to the implementation of the renewed National Cervical Screening Program relates to the introduction of the new National Cancer Screening Register. A high quality nationally consistent register is required to support the new screening pathway and provide a ‘safety net’ for women to get the follow up they need.

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Until 30 November 2017, the best source of information for management of women is the National Health and Medical Research Centre 2005 clinical management guidelines.

You may have heard that the 2016 Guidelines have been released – however, these are available for training and reference purposes only, and will not guide clinical practice until 1 December 2017. These are available on the Cancer Council Australia website.

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If a woman under the age of 25 is due to screen and visits for a Pap test prior to 1 December 2017, perform a Pap test as usual. At the time of that visit, you should let her know that:

  • The National Cervical Screening Program (NCSP) will be changing from 1 December 2017.
  • When you receive her Pap test result, you will advise her when she will be due to return for cervical screening.

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If a woman’s Pap test result is normal, she will be due to screen two years later with the new Cervical Screening Test (a primary human papillomavirus (HPV) test), and will receive an reminder from the National Cancer Screening Register (NCSR).

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If a woman’s Pap test result is normal, she will be due to screen on her 25th birthday. Under the new Program, women under the age of 25 do not need to screen as cervical cancer in this age group is very rare.

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Abnormalities in any age group should be managed according to the current clinical management guidelines.

If a woman is being managed for an abnormal result at 1 December 2017, her screening results will be transitioned to the renewed cervical screening pathway as per Section 20 of the 2016 Guidelines.

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The Commonwealth Government, with input from the pathology sector, has introduced two new MBS items. These are interim measures that have been introduced to support the pathology sector from 1 May 2017 until the renewed program is in place from 1 December 2017.

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The interim MBS pathology items relating to cervical screening came into effect on 1 May 2017. The changes included a new Medicare fee of $28.00 for the conventional cytology (Pap) test (up from $19.45) and a new MBS item for a Liquid Based Cytology (LBC) test, at a Medicare fee of $36.00.

Only pathology tests listed on the MBS can be bulk billed. The majority of pathology tests are bulk billed at the discretion of the pathology provider, when they accept the Medicare rebate (i.e. 85% of the scheduled fee for out-of-hospital services and 75% of the scheduled fee for in-hospital services) as full payment for their service.

Each patient will only be able to claim a rebate for one cervical screening test, either an LBC test or a conventional Pap test. It is important to inform women that there is no evidence that the LBC test is more effective in detecting cervical abnormalities when compared to the conventional Pap test.

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These changes will be implemented on from 1 May 2017. They are interim measures and will only be available until 30 November 2017. New MBS items for the renewed National Cervical Screening Program will come into effect from 1 December 2017.

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The Liquid Based Cytology (LBC) test is a more automated form of the conventional cytology test. Previously, it has only been available via private billing. This test has been added to the MBS in this interim period to assist the pathology sector to manage the current program. The LBC test is no more effective than a conventional cytology test. All health care providers should be guided by their pathology provider as to whether to prepare conventional slides or LBC slides between 1 May 2017 and 30 November 2017. If a woman comes in between 1 May and 30 November 2017, and she is due to be screened, do I order a conventional cytology test or an LBC test? Please liaise with your pathology provider about the scope of cervical screening technologies they offer and for advice about preparing conventional slides or LBC samples. Your local pathology provider may have a preference about preparing conventional slides or LBC samples.

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The National Bowel Cancer Screening Program (NBCSP) already has a national register that is managed by the Department of Human Services (DHS). GPs can reassure patients (aged between 50 and 74 years of age) that they will continue to receive test kits as part of the NBCSP and should continue to participate in the program.

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